Pilzsinusitis

Zusammenfassung

Die Häufigkeit von Pilzsinusitiden unterliegt erheblichen geografischen Unterschieden. Grundsätzlich werden invasive Formen von nicht-invasiven Formen unterscheiden. Invasive Pilzsinusitiden werden vor allem bei immunsupprimierten Patienten beobachtet. Zur Diagnostik ist neben dem Pilznachweis ein pilztypisches klinisches Bild erforderlich. Die Behandlung invasiver Pilzsinusitiden beruht auf chirurgischem Debridement und systemischer antimykotischer Therapie. Nicht-invasive Pilzsinusitiden werden entweder allein chirurgisch oder chirurgisch in Kombination mit einer systemischen Steroidtherapie behandelt. Die Mehrzahl der Untersuchungen zeigte keinen Vorteil einer postoperativen fungostatischen Therapie bei nicht-invasiver Pilzsinusitis.

Abstract

The incidence of fungal sinusitis is subjected to significant geographical variation. Basically, invasive and non-invasive fungal sinusitis is distinguished. Invasive fungal sinusitis is observed mainly in immunocompromised hosts. The diagnopsis is based on positive fungus detection combined with characteristic clinical features. The treatment of invasive fungal sinusitis is based on surgical debridement and systemic antifungal therapy. Non-invasive fungal sinusitis is either treated with surgery alone or surgery combined with systemic steroid therapy. The majority of studies showed no benefit of postoperative antimycotic medical treatment in patients with non-invasive fungal sinusitis.

Schlüsselwörter

Sinusitis - Pilze - NNH-Chirurgie - Antimykotika - Steroide

Key words

sinusitis - fungal infection - sinus surgery - antimycotis - steroids

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1 Muzine sind eine Familie stark glykosylierter Proteine (Glykokonjugate) mit hohem Molekulargewicht. Muzine kommen in unterschiedlichen Körperflüssigkeiten einschließlich der Muttermilch vor. Das Proteingerüst wird von einer Gruppe von etwa 20 Genen kodiert (MUC-Gene).

2 Normalwerte Gesamt-IgE: <100 IU/ml (<300 ng/ml) bei Erwachsenen, <60 IU/ml bei Kindern <200 IU/ml bei Adoleszenten.

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